ANNUAL MEETING REGISTRATION/UPDATE FORM
*Please update your group information yearly and as information changes. If you have questions,
please call the DA General Service Office at 781-453-2743 or 800-421-2383; or e-mail
info@debtorsanonymous.org
.
Date:
Your name:
Your email/phone:
Registration for:
New Meeting
Re-Registration of Existing Meeting
INFORMATION FOR
D.A. Group
BDA Group
Intergroup
GSR Area Group
Group #
Group Name
Meeting Venue
face_to_face
Phone
Internet
Video
Hybrid (F2F & Phone)
Other
Meeting Type
Open
Closed
Meeting Focus
Book Study
Steps
Tools
BDA
HOW
Other
Primary Language
None (for internet and phone)
Spanish
Portuguese
French
German
Icelandic
Hebrew
Indonesian
Cantonese
Japanese
Swedish
Russian
Italian
Estonian
Czech
English
Korean
Danish
Persian
Polish
Hindi
Tamil
Other
FACE-TO-FACE MEETING LOCATION INFORMATION
Day:
Start Time:
A.M
P.M
End Time:
A.M
P.M
Time Zone
Name of Location: (e.g. First Street Church):
Address:
City:
State:
Postal:
Country:
Handicap Accessible (check one):
Yes
No
Provide details under ADDITIONAL MEETING NOTES section below
PHONE MEETING INFORMATION
Day:
Start Time:
A.M
P.M
End Time:
A.M
P.M
Time Zone
Phone Number:
Access Code:
INTERNET MEETING INFORMATION
Day:
Start Time:
A.M
P.M
End Time:
A.M
P.M
Time Zone
Website:
Access Information:
VIDEO MEETING INFORMATION
Day:
Start Time:
A.M
P.M
End Time:
A.M
P.M
Time Zone
Platform:
Access Information:
ADDITIONAL MEETING NOTES
Use this space for additional information about your meeting, such as directions to the meeting room, or other special instructions. This information will be displayed publicly.
GROUP CONTACT INFORMATION
Primary Contact (will receive group mailings from DA General Service Office): Same as GSR
Name:
Address:
City:
State:
Postal:
Country:
Telephone:
Email:
You may contact me by:
(check all that apply)
Telephone
Mail
Email
GSR or Alternate Contact:
Name:
Address:
City:
State:
Postal:
Country:
Telephone:
Email:
You may contact me by:
(check all that apply)
Telephone
Mail
Email
Alternate Contact:
Name:
Address:
City:
State:
Postal:
Country:
Telephone:
Email:
You may contact me by:
(check all that apply)
Telephone
Mail
Email
Two contacts are required. Contact information is for GSO internal use only; no contacts are given out publicly without permission.
Do not assume we have current information for your group/contacts on file, e.g., do not write 'same as last year' or 'no changes'.
All registered meetings are assigned a 3 to 6 digit registration number by the General Service Office.
Please make a determined effort to ascertain the correct number; do not leave the group number line blank, or answer with '?' or 'don't know'.
Please click the Submit button below, or print and snail mail the completed form to the General Service Office.
No faxes please.
Does your group have a Public Information Representative?
Yes
No
Name:
Address:
City:
State:
Postal:
Country:
Telephone:
Email:
You may contact me by:
(check all that apply)
Telephone
Mail
Email